| NPI | 1306157110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101252275) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101252275) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2019-06-25 |