| NPI | 1497746754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 072206) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 072206) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: DC MD34044) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2018-08-07 |