| NPI | 1144481490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101265231) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2013-01483) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2018-08-09 |