NPI | 1467421602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NV 10781) |
Additional Taxonomies | 208600000X Surgery (Licence: SC 32458) |
2086S0102X Surgery, Surgical Critical Care (Licence: SC 32458) | |
2086S0102X Surgery, Surgical Critical Care (Licence: NV 10781) | |
Enumeration Date | 2006-03-17 |
Last Update Date | 2020-12-10 |