NPI | 1346456399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME127855) |
Additional Taxonomies | 208600000X Surgery (Licence: AL MD.32676) |
2086S0102X Surgery, Surgical Critical Care (Licence: WI 63460) | |
2086S0102X Surgery, Surgical Critical Care (Licence: NV 16532) | |
208600000X Surgery (Licence: WI 63460) | |
208600000X Surgery (Licence: CA A101528) | |
Enumeration Date | 2007-05-15 |
Last Update Date | 2022-02-04 |