| NPI | 1568437408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: CO DR.0033611) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101244709) |
| 208600000X Surgery (Licence: SC 35294) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101244709) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: SC 35294) | |
| 2086S0129X (Licence: VA 0101244709) | |
| 2086S0129X (Licence: SC 35294) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-03-06 |