| NPI | 1194139923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2019034037) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2019034037) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2024-04-25 |