| NPI | 1821189267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 036513) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 036513) |
| 208600000X Surgery (Licence: CT 036513) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2022-05-11 |