| NPI | 1275643843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD039484E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD039484E) |
| 207P00000X Emergency Medicine (Licence: PA MD039484E) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD039484E) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD039484E) | |
| 208C00000X Colon & Rectal Surgery (Licence: PA MD039484E) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD039484E) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-04-30 |