| NPI | 1164585154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: TX Q4994) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: VA 0101262983) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-06-25 |