| NPI | 1043535180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA10141900) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: RI LP03631) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2021-07-23 |