| NPI | 1659352144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 36830) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 36830) |
| 208600000X Surgery (Licence: AZ 36830) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2024-05-28 |