| NPI | 1053468140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD21994) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2017021721) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2017021721) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ME MD21994) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-03-09 |