| NPI | 1336112374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D0057842) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0057842) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0057842) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2017-12-14 |