| NPI | 1518997071 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD066263L)  | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD066263L)  | 
| Enumeration Date | 2006-07-03 | 
| Last Update Date | 2025-05-21 |