| NPI | 1992917991 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 070227)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: GA 070227)  | 
| 208600000X Surgery (Licence: TN MD45032)  | |
| Enumeration Date | 2007-05-04 | 
| Last Update Date | 2022-01-14 |