| NPI | 1255721791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0089386) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10413500) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME129763) | |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2022-09-08 |