| NPI | 1003222381 |
|---|---|
| Former Name | DEREK RAY SERNA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD463917) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 131445) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2020-04-09 |