| NPI | 1932563210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA 20A20096) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA dEA) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2022-12-20 |