| NPI | 1346238201 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD063003L)  | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD063003L)  | 
| Enumeration Date | 2005-10-13 | 
| Last Update Date | 2024-11-21 |