| NPI | 1851349849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MS 20886) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35-079001) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2014-04-01 |