| NPI | 1093974610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301111025) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301111025) |
| 208600000X Surgery (Licence: MA L-236148) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2020-02-07 |