| NPI | 1023174471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: NY 240876) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD428727) |
| 2086S0102X Surgery Surgical Critical Care (Licence: PA MD428727) | |
| 2086S0127X Surgery Trauma Surgery (Licence: NY 240876) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2013-03-11 |