| NPI | 1356495493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: TX S0389) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: TX S0389) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2023-07-03 |