| NPI | 1659466449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NE 28613) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301080920) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301080920) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-12-15 |