| NPI | 1538390026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NE 1496) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101018390) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2017-07-11 |