| NPI | 1417183435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0085739) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WV 23587) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2020-02-12 |