| NPI | 1619902129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA C192824) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 261360) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-01-16 |