| NPI | 1700028750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MT MED-PHYS-LIC-91273) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT MED-PHYS-LIC-91273) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WY TL2990) | |
| 208600000X Surgery (Licence: WY TL2990) | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2023-06-22 |