| NPI | 1518491935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0102960) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D0102960) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-09-23 |