| NPI | 1508111667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 213879) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 213879) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2013-03-06 |