| NPI | 1558569236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301090801) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MI L257964) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-04-28 |