| NPI | 1447698220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: GA 86368) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: MI 5101020643) |
| 2086S0102X Surgery Surgical Critical Care (Licence: OH 34.014005) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: GA 86368) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-10-01 |