| NPI | 1093914228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: DC MD045804) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD045804) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2021-12-29 |