| NPI | 1619238201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101263870) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: VA 0101263870) |
| 2086S0102X Surgery Surgical Critical Care (Licence: VA 0101263870) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2021-09-13 |