| NPI | 1205935624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ID MC-2857) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 04-28402) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 078646) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-05-29 |