| NPI | 1801898028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD023688E) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD023688E) |
| 208C00000X Colon & Rectal Surgery (Licence: PA MD023688E) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2009-12-18 |