| NPI | 1144377961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: RI MD12524) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 42633) |
| 2086S0127X Surgery, Trauma Surgery (Licence: RI MD12524) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TN 42633) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-01-29 |