| NPI | 1144431362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NY 242398-1) |
| Additional Taxonomies | 2086S0129X (Licence: NJ 25MA08210100) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 242398) | |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2026-05-14 |