| NPI | 1689835860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35139319) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD464946) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2020-11-16 |