| NPI | 1245643873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: AL 38508) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 32827) |
| 2086S0127X Surgery Trauma Surgery (Licence: AL 38508) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2022-08-26 |