| NPI | 1154642478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MO 2015020671) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MO 2015020671) |
| 208600000X Surgery (Licence: MO 2015020671) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2024-03-05 |