| NPI | 1114139383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MO 2004030330) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2004030330) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-10-05 |