| NPI | 1124301189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: NC 2020-04762) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2020-04762) |
| 2086S0127X Surgery Trauma Surgery (Licence: NC 2020-04762) | |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2024-07-15 |