| NPI | 1497916738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CO DR.0070626) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2012-01113) |
| 208600000X Surgery (Licence: CO DR.0070626) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2012-01113) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NC 2012-01113) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0070626) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2023-08-29 |