| NPI | 1073666301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: TX R0310) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 060599) |
| 2086S0127X Surgery Trauma Surgery (Licence: OR MD185663) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2024-05-15 |