| NPI | 1457438178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME160620) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA07517900) |
| 208600000X Surgery (Licence: PA MD057598L) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: FL ME160620) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-08-16 |