| NPI | 1861628729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD471817) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD471817) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2023-08-21 |