| NPI | 1245224369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD21292) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: DC MD21292) |
| 2086S0127X Surgery Trauma Surgery (Licence: DC MD21292) | |
| 2086X0206X Surgery Surgical Oncology (Licence: DC MD21292) | |
| 208D00000X General Practice (Licence: DC MD21292) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2010-03-26 |