| NPI | 1477583458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA G83832) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G083832) |
| 208600000X Surgery (Licence: CA G083832) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2013-12-04 |