| NPI | 1881671238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 217155) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101056084) |
| 2086X0206X Surgery, Surgical Oncology (Licence: VA 0101056084) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2025-02-27 |