| NPI | 1588610539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD469998) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD-34603) |
| 208600000X Surgery (Licence: IA 43644) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-07-13 |