| NPI | 1629144803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D33740) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101230608) |
| 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: DC MD20595) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-11-15 |