| NPI | 1104862366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NV 10890) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NV 10890) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NV 10890) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NV 10890) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2016-01-14 |