| NPI | 1528180346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: NC 2009-01141) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 54012) |
| 208600000X Surgery (Licence: NC 2009-01141) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: WV 2709) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: NC 2009-01141) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2022-04-15 |