| NPI | 1255751087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA MD-48834) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: IA MD-48834) |
| Enumeration Date | 2014-04-19 |
| Last Update Date | 2021-09-16 |