| NPI | 1295726560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: IA 36893) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: DC MD33292) |
| 2086S0102X Surgery Surgical Critical Care (Licence: IA 36893) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2012-04-27 |