| NPI | 1306800339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CA 88378) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: FL ME62857) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-07-21 |