| NPI | 1760421994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX F9831) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 15819) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX F9831) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OK 15819) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OK 15819) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-03-08 |