Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | MD071162L | PA |
NPI | 1003885955 |
---|---|
Provider Name | Rovinder Singh Sandhu |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 04/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H19551 | (02) |