| NPI | 1649711888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2022032220) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2022032220) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2022032220) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-04-25 |