| NPI | 1386858751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA 41203) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: IA 41203) |
| 2086S0102X Surgery Surgical Critical Care (Licence: IA 41203) | |
| 208600000X Surgery (Licence: PA MT184333) | |
| 208600000X Surgery (Licence: MD D74581) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2013-08-20 |