| NPI | 1194993105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME140937) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 244248) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 244248) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 244248) | |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2019-08-08 |