Individual
PAVEL VACLAV PETRIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
G74861
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
G74861
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091800
—
CA
Enumeration date
10/06/2006
Last updated
12/09/2021
Update your record
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