| NPI | 1851359681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 155154) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CT 030187) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2023-11-27 |