| NPI | 1902125701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CO DR.0059862) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD454905) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA09229500) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2018-09-05 |