NPI | 1164656161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A132760) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 57.015362) |
2086S0102X Surgery, Surgical Critical Care (Licence: NV 16473) | |
Enumeration Date | 2009-05-06 |
Last Update Date | 2024-09-04 |