| NPI | 1013064096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: NJ 25MA12034300) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: KS 0434549) |
| 2086S0127X Surgery Trauma Surgery (Licence: KS 0434549) | |
| 2086S0127X Surgery Trauma Surgery (Licence: PA MD425601) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2024-11-05 |