| NPI | 1013180447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: FL OS 10402) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34.008816) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2009-06-15 |