| NPI | 1609263193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 324994-01) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 324994-01) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2024-09-04 |