| NPI | 1164482303 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: IN 01079569A) | 
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD067578-L) | 
| 208600000X Surgery (Licence: IL 036.090092) | |
| 208600000X Surgery (Licence: OH 35.123491) | |
| 208600000X Surgery (Licence: IN 01079569A) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD067578-L) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.123491) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036.090092) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD067578-L) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.123491) | |
| Enumeration Date | 2006-03-23 | 
| Last Update Date | 2020-09-23 |