| NPI | 1851528335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX Q9616) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA os016264) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2023015014) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036.167719) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2024-03-31 |