| NPI | 1144398926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MA 244347) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME EC-05-086) |
| 2086S0102X Surgery Surgical Critical Care (Licence: SC 32081) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2016-05-16 |