| NPI | 1902829823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2006010380) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: MO 2006010380) |
| 2086S0102X Surgery Surgical Critical Care (Licence: MO 2006010380) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-04-25 |