| NPI | 1467503797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 201858) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 220783) |
| 208600000X Surgery (Licence: MA 220783) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: LA 201858) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2010-01-15 |