| NPI | 1366763658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX R0473) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX R0473) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2022-07-21 |