| NPI | 1912951542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA08268400) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME 016545) |
| 208600000X Surgery (Licence: NJ 25MA08268400) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA08268400) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-09-22 |