| NPI | 1467427526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 180612) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: NC 200201552) |
| 208600000X Surgery (Licence: SC 17969) | |
| 208600000X Surgery (Licence: NC 200201552) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2019-04-03 |