| NPI | 1578504098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 32959) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 32959) |
| 208600000X Surgery (Licence: AZ 32959) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2015-08-13 |