| NPI | 1194927228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR 58391) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX R3707) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OR 3608) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX R3707) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2024-06-27 |