| NPI | 1851376271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA08183300) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 176080) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2012-08-24 |