| NPI | 1477782100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD453021) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 5998) |
| 2086X0206X Surgery Surgical Oncology (Licence: NY 288292) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2022-07-21 |