| NPI | 1558529222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: ID O-0717) |
| Additional Taxonomies | 208600000X Surgery (Licence: WY 12895C) |
| 208600000X Surgery (Licence: MT 88821) | |
| 208600000X Surgery (Licence: ID O-0717) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: ID O-0717) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2024-06-04 |