| NPI | 1669659439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OK 5171) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 128) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TN 128) | |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2012-06-27 |