| NPI | 1982633707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301068989) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301068989) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2016-12-12 |