| NPI | 1396814737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: MA 81718) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 81718) |
| 2086S0102X Surgery Surgical Critical Care (Licence: MA 81718) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: KS 04-35626) | |
| 208600000X Surgery (Licence: KS 04-35626) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-07-05 |