| NPI | 1609255447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D98084) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA 654947) |
| 208600000X Surgery (Licence: MO 2022030140) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD473032) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2022030140) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MO 2022030140) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2023-12-05 |