| NPI | 1598750424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX L4353) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L4353) |
| 2086S0127X Surgery Trauma Surgery (Licence: TX L4353) | |
| 2086S0129X Surgery Vascular Surgery (Licence: TX L4353) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2023-10-10 |