| NPI | 1720199151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 217205) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 217205) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 217205) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 217205) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-10 |