| NPI | 1710965462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A96189) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A96189) |
| 208600000X Surgery (Licence: NV 11045) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NV 11045) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-02-28 |