| NPI | 1649474685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0102206860) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2013043015) |
| 208600000X Surgery (Licence: TN DO0000002427) | |
| 208600000X Surgery (Licence: GA 90623) | |
| 208600000X Surgery (Licence: VA 0102206860) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2013043015) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 90623) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TN DO0000002427) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2022-05-20 |