| NPI | 1902926751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35-097297) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 251457) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-01-09 |