| NPI | 1487700779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA A 112500) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A 112500) |
| 208600000X Surgery (Licence: NY 247995) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: NY 247995) | |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2025-11-17 |