| NPI | 1831386077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ND 13089) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND 13089) |
| 208600000X Surgery (Licence: TX BPI0026040) | |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2023-03-07 |