| NPI | 1144209842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: AZ 49959) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX M5738) |
| 2086S0102X Surgery Surgical Critical Care (Licence: TX M5738) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA A93582) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2015-02-17 |