| NPI | 1295222495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX U8702) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR PG188212) |
| 208600000X Surgery (Licence: TX U8702) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2023009445) | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2024-08-08 |