| NPI | 1588616148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: OH 35064289) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35064289) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2013-09-24 |