| NPI | 1407819535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: GA 068873) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME108074) |
| 2086S0102X Surgery Surgical Critical Care (Licence: FL ME108074) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CT 042564) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2019-05-20 |