| NPI | 1841480704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 235983) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 230540) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2013-12-11 |