| NPI | 1811187057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX N0602) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX N0602) |
| 208600000X Surgery (Licence: LA 200236) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2025-09-12 |