| NPI | 1821478025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: AZ 66425) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: TN 61346) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2022-09-13 |