| NPI | 1164624839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G87771) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G87771) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA G87771) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-07-08 |