| NPI | 1417489030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA12737400) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.151275) |
| 208600000X Surgery (Licence: NJ 25MA12737400) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.151275) | |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2025-09-17 |