| NPI | 1619318482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 293213) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS019383) |
| 208600000X Surgery (Licence: NJ 25mb10962800) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MB10962800) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2023-07-18 |