| NPI | 1043415755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35126492) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35126492) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2021-07-27 |