| NPI | 1598058646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A165907) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD468229) |
| 208600000X Surgery (Licence: CA 165907) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA A165907) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2024-04-27 |