| NPI | 1861913923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OK 41132) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2021017472) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2023-11-13 |