| NPI | 1477686905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: DE C2-0011822) |
| Additional Taxonomies | 208600000X Surgery (Licence: DE C7-0002936) |
| 2086S0102X Surgery Surgical Critical Care (Licence: NJ MB08839000) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2016-11-29 |