| NPI | 1356902464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 1356902464) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301507098) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2024-06-04 |