| NPI | 1821050113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD417574) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 257497) |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA md417574) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-10-02 |