| NPI | 1093033482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: DE C2-0010151) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT011869) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2012-10-03 |