| NPI | 1568641850 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD473071) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 280606) | 
| 208600000X Surgery (Licence: OH 57013474) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101259863) | |
| Enumeration Date | 2007-11-02 | 
| Last Update Date | 2023-07-31 |