| NPI | 1447216981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: RI MD15696) |
| Additional Taxonomies | 2086S0129X (Licence: NH 16212) |
| 2086S0129X (Licence: NY 214947) | |
| 2086S0129X (Licence: CT 56042) | |
| 208600000X Surgery (Licence: NY 214947) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-04-28 |