| NPI | 1003832254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NE 29250) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 200501674) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NC 200501674) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-07-10 |