| NPI | 1962445361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 018609) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: GA 018609) |
| 2086S0102X Surgery Surgical Critical Care (Licence: SC 22149) | |
| 208600000X Surgery (Licence: SC 22149) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2009-07-10 |