| NPI | 1972696417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: PA MD043521E) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD043521EP) |
| 2086H0002X Surgery Hospice and Palliative Medicine (Licence: PA MD043521E) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-12-07 |