| NPI | 1013336890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 86109) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD469835) |
| 208600000X Surgery (Licence: PA MD469835) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2025-09-10 |