| NPI | 1629278510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 046627) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 46627) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2021-11-11 |