| NPI | 1144541426 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 76388) | 
| Additional Taxonomies | 208600000X Surgery (Licence: UT 10714776-1205) | 
| 208600000X Surgery (Licence: AZ 76388) | |
| Enumeration Date | 2010-06-21 | 
| Last Update Date | 2025-04-24 |