| NPI | 1033292974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101250069) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 248905) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 248905) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 248905) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-12-07 |