| NPI | 1265448500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 73150) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: SC MD37935) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX K5294) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101268805) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 73150) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2025-03-05 |