NPI | 1386848950 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX N0135) |
Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX TEMP) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2016-12-19 |