| NPI | 1285096420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 90919) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 87924) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 90919) | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2023-08-15 |