| NPI | 1306292164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 69668) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 0000064261) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2023-09-01 |