| NPI | 1295928737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA08450100) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA08450100) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA08450100) | |
| Enumeration Date | 2007-08-18 |
| Last Update Date | 2009-03-20 |