| NPI | 1598887176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA C181752) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301085425) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA C181752) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301085425) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2022-10-12 |