| NPI | 1417247982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD462204) |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2022-07-21 |