| NPI | 1780966788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME136006) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09264300) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA09264300) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 278824) | |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2021-03-03 |