| 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 |