| NPI | 1093008617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 81157) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WI 81157) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2023-08-29 |