| NPI | 1922096965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD025159E) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD025159E) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2016-06-02 |