| NPI | 1396124723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX V2999) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX V2999) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2024-08-29 |