| NPI | 1467492504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: GA 044546) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 044546) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 044546) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-02-13 |