| NPI | 1659832384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA12801300) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MA 1018925) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-07-28 |