| NPI | 1245452606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101288192) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME98528) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ID M-17692) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101288192) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2026-01-28 |