| NPI | 1326380114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.140493) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.140493) |
| 208600000X Surgery (Licence: FL TRN19181) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2020-10-09 |