| NPI | 1932387198 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: UT 7675946-1205)  | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: UT 76759461205)  | 
| Enumeration Date | 2008-02-08 | 
| Last Update Date | 2017-02-03 |