| NPI | 1285945428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 076300) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NJ 208d00000x) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2021-06-23 |