| NPI | 1538431994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 258376) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 258376) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NC 258376) | |
| 208D00000X General Practice (Licence: NE 27650) | |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2020-12-10 |