| NPI | 1881692200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 231307) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 231307) |
| Enumeration Date | 2005-07-10 |
| Last Update Date | 2011-08-03 |