| NPI | 1053550301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 48625) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R70173) |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2024-11-22 |