| NPI | 1942503610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MA09339700) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09339700) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2015-02-24 |