| NPI | 1194934299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD428722) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: PA MD428722) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-06-11 |