| NPI | 1295793149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: SC 91224) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: GA 72444) |
| 2086S0127X Surgery Trauma Surgery (Licence: NY 264501) | |
| 2086S0127X Surgery Trauma Surgery (Licence: NE 28147) | |
| 2086S0127X Surgery Trauma Surgery (Licence: FL ME95504) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: SC 91224) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2024-03-13 |