| NPI | 1942463963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101247280) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0083805) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2025-07-03 |