| NPI | 1144304262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME159559) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D72676) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MD D72676) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-01-26 |