| NPI | 1346460169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX P2645) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 28468) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AL 28468) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2025-07-25 |