| NPI | 1154303998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D72565) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A63985) |
| 208600000X Surgery (Licence: CA A63985) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2023-04-05 |