| NPI | 1982947784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101265483) |
| Additional Taxonomies | 208600000X Surgery (Licence: GU M-2211) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GU M-2211) | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2023-10-26 |