NPI | 1134416860 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CT 56655) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 313539) |
208600000X Surgery (Licence: NJ 25MA10824500) | |
Enumeration Date | 2011-07-01 |
Last Update Date | 2025-09-19 |