| NPI | 1467747071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD462020) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD.207139) |
| 208600000X Surgery (Licence: CT 55402) | |
| 208600000X Surgery (Licence: PA MD462020) | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2020-08-31 |