| NPI | 1568874071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME155999) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 60316) |
| 208600000X Surgery (Licence: AZ R74317) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TN 60316) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2022-09-02 |