| NPI | 1609842343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 182640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 182640) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-12-04 |