| NPI | 1558552679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 2603) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MA 0000) |
| 208600000X Surgery (Licence: MA L-233602) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-01-11 |