| NPI | 1285874834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OK 27713) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME103630) |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2013-05-08 |