| NPI | 1932147311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 29574) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 29574) |
| 208600000X Surgery (Licence: TX N8423) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MA 272743) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-08-16 |