NPI | 1093917221 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: PA MD459118) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD459118) |
2086S0127X Surgery Trauma Surgery (Licence: KY 46080) | |
Enumeration Date | 2007-06-01 |
Last Update Date | 2022-07-21 |