| NPI | 1144647330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101025075) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 5101025075) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2021-03-29 |