| NPI | 1124288725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35134576) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME114066) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: SC 37956) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2019-06-05 |