| NPI | 1912105495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA12203300) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MD D0070965) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2024-05-30 |