| NPI | 1649226135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 279399) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08247400) |
| 208600000X Surgery (Licence: MA 227966) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 279399) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA08247400) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2021-09-29 |