| NPI | 1518160456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.093826) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57006568) |
| 208600000X Surgery (Licence: OH 35.093826) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2015-06-30 |