| NPI | 1285673079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: DC MD17936) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D36081) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-08-02 |