| NPI | 1871524694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD30831E) |
| Additional Taxonomies | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: PA MD30831E) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-05-21 |