| NPI | 1700271178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD24256) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT207986) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2020016495) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD470306) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ME MD24256) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: ME MD24256) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2022-03-10 |