| NPI | 1356546683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA08889100) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 57.012145) |
| 208600000X Surgery (Licence: PA MD436827) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2016-07-25 |