| NPI | 1407882616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 31451) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD046887) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: SC 31451) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: SC 31451) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2019-04-30 |