| NPI | 1699770081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 1453041) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NJ MA50604) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2013-08-30 |