| NPI | 1235199407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 082385) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX M2735) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2019-03-07 |