| NPI | 1447478896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 54421) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 181577) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2016-07-05 |