| NPI | 1801283700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: CT 072523) |
| Additional Taxonomies | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: CT 556300) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2025-09-23 |