| NPI | 1306112586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: FL ME149575) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0061992) |
| 208600000X Surgery (Licence: FL ME149575) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CO DR.0061992) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: FL ME149575) | |
| 2086S0127X Surgery Trauma Surgery (Licence: CO DR.0061992) | |
| Enumeration Date | 2012-04-01 |
| Last Update Date | 2021-05-04 |