| NPI | 1417983644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME86695) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD 40449) |
| 208600000X Surgery (Licence: MS 19691) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2016-11-11 |