| NPI | 1831340769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX Q5725) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q5725) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2022-04-05 |