| NPI | 1679866552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX V3631) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX V3631) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2025-06-10 |