| NPI | 1144285750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2014-01522N) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 30498) |
| 2086S0102X Surgery Surgical Critical Care (Licence: NC 2014-01522) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CO 50555) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2022-01-28 |