| NPI | 1275789430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: MD D84537) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA09752900) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA09752900) | |
| 2086S0129X (Licence: NJ 25MA09752900) | |
| 2086S0129X (Licence: PA MD446266) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2022-10-25 |