| NPI | 1285049023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NH 24832) | 
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102206066) | 
| 208600000X Surgery (Licence: FL UO4281) | |
| Enumeration Date | 2014-06-30 | 
| Last Update Date | 2023-11-01 |