| NPI | 1720260920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 249935) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 053199) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MA 250534) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2017-11-30 |