| NPI | 1851381339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD450250) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00047349) |
| 208600000X Surgery (Licence: MI 4301086111) | |
| 208600000X Surgery (Licence: NY 225395) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: AR E-7559) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2025-08-08 |