| NPI | 1427077288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA05853300) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 162371) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-11-01 |