| NPI | 1154438133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX L6843) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 46604) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-04-09 |