| NPI | 1003020116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2009027536) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2009027536) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-01-30 |