| NPI | 1245559699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 280593) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 280593) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2024-07-30 |