| NPI | 1013941202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2015020167) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX L1328) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX L1328) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-08-07 |