| NPI | 1568587277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 241411) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MA 241411) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MA 241411) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2011-05-31 |