| NPI | 1730149535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD 072429-L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD 072429-L) |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD 072429-L) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-07-21 |