| NPI | 1184796187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA10772200) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD0000038303) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME133771) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-04-16 |