| NPI | 1356316525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA05933500) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA05933500) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2024-02-14 |