NPI | 1558568733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 5101017324) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 5101017324) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2021-02-12 |