| NPI | 1477554079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 025420) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: LA 025420) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2021-03-26 |