| NPI | 1356802797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A181793) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 1017540) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-05-16 |