| NPI | 1083115794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX V2142) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 322077) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX V2142) | |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2024-09-17 |