| NPI | 1396902870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101250761) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101250761) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-06-24 |