| NPI | 1043441736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 1287) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34.011731) |
| 208600000X Surgery (Licence: SC 1287) | |
| 208600000X Surgery (Licence: SC LL1287) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2021-01-27 |