| NPI | 1366621898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 258825-1) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 258825-1) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 258825-1) | |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2019-11-05 |