| NPI | 1912943010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME155518) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 188036) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NY 188036) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2022-05-02 |