| NPI | 1356398366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MA 281020) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D46937) |
| 2086S0102X Surgery Surgical Critical Care (Licence: MD D46937) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2019-09-13 |