| NPI | 1174643290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR-45221) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CO DR.0045221) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2023-03-07 |