| NPI | 1780035808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD H97764) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD H97764) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2023-07-10 |