| NPI | 1588789655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0099425) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A77295) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2024-03-04 |