| NPI | 1497921365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 61744) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: CT 61744) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2024-03-12 |