| NPI | 1962732115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MB09152400) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MB09152400) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MB09152400) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CT 053828) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 262364) | |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2015-08-07 |