| NPI | 1396994026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 61348) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 78976) |
| 208600000X Surgery (Licence: NC 2016-00346) | |
| 208600000X Surgery (Licence: TN 46316) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TN 46316) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2016-00346) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 78976) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TN 46316) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 78976) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NC 2016-00346) | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2022-10-22 |