| NPI | 1871751917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: RI MD14671) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD445446) |
| 208600000X Surgery (Licence: PA MD445446) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2020-01-29 |