| NPI | 1942648837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301508248) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 291464) |
| 208600000X Surgery (Licence: IL 125-063214) | |
| 208600000X Surgery (Licence: IL 036141167) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: NM MD2020-0757) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2023-02-08 |