| NPI | 1346392032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX L1383) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: TX L1383) |
| 2086S0127X Surgery Trauma Surgery (Licence: TX L1383) | |
| 2086X0206X Surgery Surgical Oncology (Licence: TX L1383) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-12-11 |