| NPI | 1386940765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA09650900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 285970) |
| 208600000X Surgery (Licence: NJ 25MA09650900) | |
| 208600000X Surgery (Licence: PA MD482413) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 285970) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA09650900) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD482413) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 285970) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD482413) | |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2023-10-24 |