| NPI | 1740246099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ MA01983400) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 090825) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-07-12 |