| NPI | 1063704237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CA 20A15648) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: CA 2OA15648) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2022-01-06 |