| NPI | 1518043272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA03319000) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA03319000) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |