NPI | 1124219381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: PA MT189539) |
Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MT 189539) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2019-07-06 |