| NPI | 1912970435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 259782) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 259782) |
| 208600000X Surgery (Licence: CT 45107) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: CT 45107) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2021-02-18 |