| NPI | 1164734687 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA10552200)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 284685)  | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA10552200)  | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 284685)  | |
| Enumeration Date | 2010-07-13 | 
| Last Update Date | 2024-04-08 |