| NPI | 1083931166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CT 64711) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: CT 64711) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2020-01-15 |