| NPI | 1649384967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA12870400) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD458795) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CT 037568) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2025-10-29 |