| NPI | 1548246002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 220505) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 153441) |
| 2086X0206X Surgery, Surgical Oncology (Licence: PA MD437995) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2015-04-07 |