| NPI | 1598755316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: WI 65684) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA05459000) |
| 208600000X Surgery (Licence: WI 65684) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2021-11-30 |