| NPI | 1154769008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 93111) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 93111) |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 93111) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-09-30 |