| NPI | 1780189688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ME MD30362) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NV 24989) |
| 208600000X Surgery (Licence: NV 24989) | |
| 208600000X Surgery (Licence: ME MD30362) | |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2026-03-31 |