| NPI | 1306808019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CT 69621) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 69621) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MD D0063229) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MD D63229) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2021-10-13 |