| NPI | 1174504856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 038032) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 038032) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2013-02-06 |