| NPI | 1023049335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ID MC-2670) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 16881) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-03-04 |