| NPI | 1114976099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G85975) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MS 20331) |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD428718) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-07-21 |