| NPI | 1205095817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: AZ APPLIED FOR) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: AZ APPLIED FOR) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |