| NPI | 1073752366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 222783) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 222783) |
| 208600000X Surgery (Licence: RI MD15535) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2023-01-25 |