| NPI | 1033373279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX Q8905) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT190540) |
| 208600000X Surgery (Licence: TX Q8905) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2022-07-22 |