| NPI | 1093030256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 278390) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 269512) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 278390) | |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2020-10-22 |