| NPI | 1881605848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G72104) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: CT G72104) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2010-01-15 |