| NPI | 1740663368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2021025411) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2021025411) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2021025411) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2025-04-17 |