| NPI | 1659804375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME163660) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME163660) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2025-06-03 |