| NPI | 1053467894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: FL ME150816) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 27745) |
| 208600000X Surgery (Licence: CA A99319) | |
| 208600000X Surgery (Licence: TX R2163) | |
| 208600000X Surgery (Licence: NY 303595) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: TX R2163) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: OK 27745) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: NY 303595) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA A99319) | |
| 2086S0127X Surgery Trauma Surgery (Licence: OK 27745) | |
| 2086S0127X Surgery Trauma Surgery (Licence: NY 303595) | |
| 2086S0127X Surgery Trauma Surgery (Licence: TX R2163) | |
| 2086S0127X Surgery Trauma Surgery (Licence: CA A99319) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-06-07 |