| NPI | 1689643637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX R8186) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TN MD0000064204) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ID MC-0432) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 73960) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MS 27572) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NV 19524) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX R8186) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101273072) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WY 10838A) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME152606) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CO CDRH.0055039) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-08-28 |