| NPI | 1386696755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ MA043101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA043101) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2009-09-29 |