| NPI | 1972600344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A75418) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 13342087-1205) |
| 208600000X Surgery (Licence: AZ 63430) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: AZ 63430) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-07-21 |