| NPI | 1174571327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101241969) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: VA 0101241969) |
| 2086S0127X Surgery Trauma Surgery (Licence: VA 0101241969) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-09-09 |