| NPI | 1568696235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD177896) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD177896) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2023-08-30 |