| NPI | 1710957352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD425103) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 200100652) |
| 208600000X Surgery (Licence: PA MD425103) | |
| 208600000X Surgery (Licence: GA 90128) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2023-10-12 |