| NPI | 1821520107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA OS023953) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 73584) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-09-09 |