| NPI | 1497252605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 330862) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX U4386) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2024-09-03 |