| NPI | 1134353592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA11369600) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 241908-1) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2022-07-28 |