| NPI | 1942380936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35085710) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME101689) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2022-01-05 |