| NPI | 1831116425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G40233) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 229518) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-08-27 |