| NPI | 1366782930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2023-02501) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 62752) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TN 62752) | |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2024-05-17 |