| NPI | 1922325539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 282412) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 9794583) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2018-06-27 |