| NPI | 1417196254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2015025844) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2015025844) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2021-07-26 |