| NPI | 1154664282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0068718) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 5267810-1205) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: UT 5267810-1205) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2022-07-13 |