NPI | 1376737874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME163370) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2022007281) |
208600000X Surgery (Licence: GA 074569) | |
208600000X Surgery (Licence: CA A101986) | |
Enumeration Date | 2007-08-28 |
Last Update Date | 2023-08-10 |