| NPI | 1336186071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2004000957) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MO 2004000957) |
| 208600000X Surgery (Licence: KS 04-50349) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: KS 04-50349) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MO 2004000957) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2024-12-11 |