| NPI | 1659358018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 130605) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: NY 130605) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2008-01-07 |