| NPI | 1124289350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101282491) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD452246) |
| 208600000X Surgery (Licence: VA 0101282491) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2024-09-23 |