| NPI | 1518124072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD459200) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT193163) |
| 208600000X Surgery (Licence: MI 4301105272) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301105272) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD459200) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2016-09-21 |