| NPI | 1881665115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 40781) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD062565L) |
| 208600000X Surgery (Licence: LA 08857R) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD062565L) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD062565L) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2017-12-14 |