| NPI | 1568446474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G71624) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G71624) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2016-03-24 |