| NPI | 1568546034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA07584600) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 221158) |
| 208600000X Surgery (Licence: NJ 25MA07584600) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-04-26 |