| NPI | 1558391383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 33001) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: VT 042-0010688) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-08-16 |