| NPI | 1568568533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2010039555) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 43856) |
| 207P00000X Emergency Medicine (Licence: MO 2010039555) | |
| 208600000X Surgery (Licence: KY 43856) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: KY 43856) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2010039555) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2011-03-09 |