| NPI | 1700028172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: VA 0101259042) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101259042) |
| 2086S0127X Surgery Trauma Surgery (Licence: VA 0101259042) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2024-03-21 |