| NPI | 1942591201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA OS020586) |
| Additional Taxonomies | 208600000X Surgery (Licence: DE C2-0011690) |
| 208600000X Surgery (Licence: PA OS020586) | |
| 208600000X Surgery (Licence: DE Pending) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2020-07-10 |