| NPI | 1750425278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G87433) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G87433) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA G87433) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2023-09-22 |