| NPI | 1740542372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: DE C1-0010558) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT189425) |
| 208600000X Surgery (Licence: DE C1-0010558) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2014-01-03 |