| NPI | 1063825693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA R10054) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IA R10054) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CO DR.0061901) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IA R10054) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0061901) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: IA R10054) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0061901) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2022-09-01 |