| NPI | 1598947236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX K5800) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: TX K5800) |
| 2086S0127X Surgery Trauma Surgery (Licence: TX K5800) | |
| 2086X0206X Surgery Surgical Oncology (Licence: TX K5800) | |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2022-05-10 |