| NPI | 1881669851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 9900019) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 9900019) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2025-09-11 |