NPI | 1861650012 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: SC 83220) |
Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: PA MD453463) |
2086S0102X Surgery Surgical Critical Care (Licence: SC 83220) | |
Enumeration Date | 2008-05-23 |
Last Update Date | 2022-01-04 |