| NPI | 1629068457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA04355800) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA04355800) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2018-04-24 |