| NPI | 1609973700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ MA080222) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD050836L) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-05-05 |