| NPI | 1548518962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CO TL0007028) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 305284) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2021-12-20 |