| NPI | 1134566037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OR MD211178) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD211178) |
| 208600000X Surgery (Licence: VA 0104258440) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD211178) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0104258440) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: VA 0104258440) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2023-08-18 |