| NPI | 1548298425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 35096) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 35096) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 35096) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: AZ 35096) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2015-12-02 |