| NPI | 1689875973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086H0002X Surgery Hospice and Palliative Medicine (Licence: NY 213636) |
| Additional Taxonomies | 2086H0002X Surgery Hospice and Palliative Medicine (Licence: NJ 25MA07572000) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2007-07-08 |