| NPI | 1215939434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD034196E) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: PA MD034196E) |
| 2086S0129X Surgery Vascular Surgery (Licence: PA MD034196E) | |
| 208C00000X Colon & Rectal Surgery (Licence: PA MD034196E) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2016-07-14 |