| NPI | 1649478116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 83727) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 83727) |
| 208600000X Surgery (Licence: AL 1642) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2020-05-27 |