| NPI | 1396799565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: PA MD428666) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: NJ 25MA08002700) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2015-09-24 |