| NPI | 1730488396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2018020869) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2018020869) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MO 2018020869) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2022-12-07 |