| NPI | 1972035079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 294237) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 294237) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NH 22900) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2022-10-18 |