| NPI | 1891761292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D77517) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD037034E) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2014-06-02 |