| NPI | 1013448554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 70284) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A157976) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-06-14 |