| NPI | 1568416618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 256179) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 224660) |
| 2086X0206X Surgery, Surgical Oncology (Licence: MD D73814) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-02-27 |