| NPI | 1023192663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A92657) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 229423) |
| 208600000X Surgery (Licence: CA A92657) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA A92657) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME106864) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-03-23 |