| NPI | 1609988039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS009010L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS009010L) |
| 207P00000X Emergency Medicine (Licence: PA OS009010L) | |
| 2086S0120X Surgery Pediatric Surgery (Licence: PA OS009010L) | |
| 2086S0129X Surgery Vascular Surgery (Licence: PA OS009010L) | |
| 208C00000X Colon & Rectal Surgery (Licence: PA OS009010L) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA OS009010L) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-06-13 |