| NPI | 1689802753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: PA MD444444) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD444444) |
| 2086S0102X Surgery Surgical Critical Care (Licence: PA MD444444) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2025-06-20 |