| NPI | 1659398287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 277774) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 118126) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NY 277774) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-05-15 |