| NPI | 1699437897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA11967100) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 307953) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2024-01-31 |