| NPI | 1346402500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD165922) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD165922) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2022-02-04 |