| NPI | 1811928500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2006-00470) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2006-00470) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-12-18 |