| NPI | 1063674190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CA CA209062) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 20A9062) |
| 2086S0102X Surgery Surgical Critical Care (Licence: FL OS 12023) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: DC DO034774) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2023-05-04 |