| NPI | 1407267545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: NC 2020-02743) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2020-02743) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2023-05-04 |