| NPI | 1508898099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD00039280) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A73499) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A73499) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ID M-16494) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA A73499) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-10-26 |