| NPI | 1548257405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101269358) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX s8193) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35-057183) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.057183) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: ID M-16154) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-08-22 |