NPI | 1972569374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ MA39654) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ MA39654) |
Enumeration Date | 2006-04-25 |
Last Update Date | 2007-07-16 |