| NPI | 1962498931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 216279) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NY 216479) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2013-01-14 |