| NPI | 1518072156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2018-01072) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101232753) |
| 208600000X Surgery (Licence: NC 2018-01072) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101232753) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2021-05-26 |