| NPI | 1053587972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D82171) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0116017752) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD440118) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: SC 35249) | |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2016-09-01 |