| NPI | 1659481414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: NY 284395) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: PA MD063149L) |
| 2086S0127X Surgery Trauma Surgery (Licence: NY 284395) | |
| 208600000X Surgery (Licence: NY 284395) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-11-27 |