| NPI | 1932116530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA12788700) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 228086) |
| 208600000X Surgery (Licence: NY 265290) | |
| 204F00000X Transplant Surgery (Licence: NJ 25MA12788700) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-09-30 |