| NPI | 1164626594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A146490) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: WI 50424) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A146490) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2024-04-08 |