| NPI | 1275981417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA11088000) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA11088000) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2023-08-18 |