| NPI | 1356370894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2013-01765) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM 99-256) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2013-01765) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NM 99-256) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-02-08 |