| NPI | 1063529881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0072421) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 50634) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MN 50634) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-06-21 |