| NPI | 1619011657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA10691400) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 242159) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2026-03-12 |