| NPI | 1831741321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101286446) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101286446) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2026-08-14 |