| NPI | 1043300676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: UT 170734-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 170734-1205) |
| 2086S0127X Surgery Trauma Surgery (Licence: UT 170734-1205) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-04-28 |