| NPI | 1437460862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: AZ 56153) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 56153) |
| 208600000X Surgery (Licence: AZ R72232) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2023-05-09 |