| NPI | 1013121243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2011010490) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2011010490) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2018-01-24 |