| NPI | 1710161807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA09888900) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX Q3597) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2016-07-18 |