| NPI | 1144518697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD448141) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 273137) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 273137) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2015-01-20 |