| NPI | 1124386909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A126011) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A126011) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2024-04-25 |