| NPI | 1992769657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NY 139208) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 139208) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 139208) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2008-03-31 |