| NPI | 1275763567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2012-01270) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2012-01270) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2023-12-18 |