| NPI | 1437385085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: NJ 25MA09698700) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: NJ 25MA09698700) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2024-04-25 |