| NPI | 1326126590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA09309600) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 228918) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA09309600) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2024-04-25 |