| NPI | 1699017509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0102208879) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102208879) |
| 208600000X Surgery (Licence: MO 2019022428) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2019022428) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2025-02-13 |