| NPI | 1992148068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 283119) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086X0206X Surgery, Surgical Oncology (Licence: NJ 25MB10318100) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2023-12-05 |