| NPI | 1609192509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL OS14800) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 278508) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2021-08-21 |