| NPI | 1609806686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA06931300) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA06931300) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2013-07-02 |