| NPI | 1447469135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WY 8454A) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 4301084487) |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: WY 8454A) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: WY 8454A) | |
| 2086S0127X Surgery Trauma Surgery (Licence: WY 8454A) | |
| 2086S0129X Surgery Vascular Surgery (Licence: WY 8454A) | |
| 2086X0206X Surgery Surgical Oncology (Licence: WY 8454A) | |
| 208C00000X Colon & Rectal Surgery (Licence: WY 8454A) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WY 8454A) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2012-01-26 |