| NPI | 1639197874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CO DR.0071965) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: NJ 25MA05176200) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-10-23 |