| NPI | 1992743850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME110310) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX F9847) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2011-08-31 |