| NPI | 1518921758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: WV 26259) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 223363) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 223363) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-04-15 |