| NPI | 1265648794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: OH 35089515) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: OH 35089515) |
| 208600000X Surgery (Licence: OH 35.089515) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2018-03-09 |