| NPI | 1437320710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ND 11246) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 50591) |
| 208600000X Surgery (Licence: ND 11246) | |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2018-06-06 |