| NPI | 1871910497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 34.013205) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34.013205) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2020-03-06 |