| NPI | 1083033971 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2020-02270) | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2020-02270) | 
| Enumeration Date | 2014-04-08 | 
| Last Update Date | 2024-07-15 |