| NPI | 1093241267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA11495100) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT212782) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2022-06-24 |