| NPI | 1437147865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: TX R4136) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: MO 2012021382) |
| 2086S0127X Surgery Trauma Surgery (Licence: MO 2012021382) | |
| 2086S0127X Surgery Trauma Surgery (Licence: NC 200000607) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2022-07-21 |