NPI | 1902269624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: OR MD221421) |
Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OR MD221421) |
208600000X Surgery (Licence: NY 300169) | |
Enumeration Date | 2016-03-30 |
Last Update Date | 2025-07-16 |