| NPI | 1154355626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX L2663) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 36432) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX L2663) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-12-07 |