| NPI | 1568788594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 66426) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A142628) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AR E-14873) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CO DR.0060712) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2022-10-24 |