| NPI | 1598728735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G82149) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G82149) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2010-12-14 |