| NPI | 1518048586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2005-01604) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101045377) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2005--01604) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2025-08-13 |