| NPI | 1548423213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101260732) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101260732) |
| 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101260732) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-09-09 |