| NPI | 1881665560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA08980800) |
| Additional Taxonomies | 208600000X Surgery (Licence: DE C10006986) |
| 208600000X Surgery (Licence: NJ 25MA08980800) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-04-29 |