| NPI | 1396900064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MN 76734) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A95420) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2024-07-09 |