| NPI | 1265498257 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35075304) | 
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35075304) | 
| 2086S0102X Surgery, Surgical Critical Care (Licence: IN 01075767A) | |
| 208600000X Surgery (Licence: IN 01075767A) | |
| Enumeration Date | 2006-04-26 | 
| Last Update Date | 2025-10-02 |