| NPI | 1356325104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A75460) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA 00A754600) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA 00A754600) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2021-12-13 |