| NPI | 1851382105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101227972) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: DC MD32705) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2024-03-21 |