| NPI | 1508932666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D0047202) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0047202) |
| 2086S0129X (Licence: MD D0047202) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2008-03-05 |