| NPI | 1952834533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MO 2024028614) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MO 2024028614) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2025-04-17 |