| NPI | 1508158627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA10407600) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10407600) |
| Enumeration Date | 2011-05-08 |
| Last Update Date | 2024-04-27 |