| NPI | 1568499598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301047185) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 047185) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2021-03-05 |