| NPI | 1083634489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX L6902) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L6902) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-08-13 |