| NPI | 1316311509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A204074) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A204074) |
| 207P00000X Emergency Medicine (Licence: CA A204074) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CA F406) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA A204074) | |
| 208600000X Surgery (Licence: CA A204074) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A204074) | |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2025-07-23 |