| NPI | 1275706277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101275547) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 247599) |
| 2086S0102X Surgery Surgical Critical Care (Licence: MA 247599) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: VA 0101275547) | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2024-04-15 |