| NPI | 1275717845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 274882-1) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 274882-1) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2019-07-12 |