| NPI | 1487735122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MS 19827) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MS 19827) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2013-10-23 |