| NPI | 1083816094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 22102) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO TL 679) |
| 208600000X Surgery (Licence: ME 017470) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2025-03-11 |