| NPI | 1285857391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 68090) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301079114) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 68090) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2013-08-19 |