| NPI | 1386092922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: OK 32287) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 32287) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2025-09-03 |