| NPI | 1477580462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 278809) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 265457-1) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-04-22 |