| NPI | 1003071903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CO DR.0058646) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: CO DR.0058646) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2022-09-21 |