| NPI | 1447410014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA09248900) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA09248900) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2023-01-27 |