| NPI | 1649384967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD458795) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 037568) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2018-02-02 |