| NPI | 1275748386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 078779) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD437006) |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 078779) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME118768) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2019-10-08 |