| NPI | 1417268418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: TX S2880) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S2880) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2022-02-23 |