| NPI | 1174783013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD441695) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA mt188082) |
| 208600000X Surgery (Licence: PA MD441695) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME114014) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2013-08-21 |