| NPI | 1881924801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MT220269) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD472249) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2021-04-04 |