| NPI | 1588735674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 248676) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 216441) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2016-06-30 |