| NPI | 1659461275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: UT 161530-1205) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: UT 161530-1205) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-09-27 |