| NPI | 1407816721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD-059559-L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD-059559-L) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD-059559-L) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-12-09 |