| NPI | 1225029739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MI 4301056701) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI TW056701) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301056701) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2021-06-04 |