| NPI | 1487066866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101275411) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 62964) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2022-07-21 |