| NPI | 1417938853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD043009L) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD043009L) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2019-11-06 |