| NPI | 1255592358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD441506) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 190299) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2020-08-31 |