| NPI | 1316978877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301070008) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L7591) |
| 208600000X Surgery (Licence: MI 4301070008) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX L7591) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX L7591) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-01-15 |