| NPI | 1245767060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 317247) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 317247) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2026-02-17 |