| NPI | 1235134628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS006127L) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2003-00997) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA OS006127L) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA OS006127L) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2020-08-19 |