| NPI | 1619312766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX R7007) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX R7007) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX R7007) | |
| 208D00000X General Practice (Licence: TX R7007) | |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2024-04-17 |