| NPI | 1912964537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA04519200) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA04519200) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: NJ 25MA04519200) | |
| 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA04519200) | |
| 174400000X Specialist (Licence: NJ 25MA04519200) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA04519200) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-03-04 |