| NPI | 1679676795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX M4815) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01070094) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-11 |