NPI | 1063853539 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA OS017951) |
Additional Taxonomies | 208600000X Surgery (Licence: PA OT015093) |
Enumeration Date | 2013-07-12 |
Last Update Date | 2019-11-20 |