| NPI | 1174533061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 296662) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 044420) |
| 174400000X Specialist (Licence: CT 044420) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-01-24 |