| NPI | 1295719276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G76281) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G76281) |
| 208600000X Surgery (Licence: CA G76281) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2016-03-24 |