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 |