| NPI | 1295915536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: UT 7643802-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 7643802-1205) |
| 2086S0127X Surgery, Trauma Surgery (Licence: UT 7643802-1205) | |
| Enumeration Date | 2007-11-03 |
| Last Update Date | 2023-03-07 |