| NPI | 1740240928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD 056473L) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: PA MD056473L) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2011-07-22 |