| NPI | 1760477533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD60692832) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 22675) |
| 208600000X Surgery (Licence: ID MC-2320) | |
| 208600000X Surgery (Licence: WA MD60692832) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: SC 37301) | |
| 208600000X Surgery (Licence: IL 036114071) | |
| 208600000X Surgery (Licence: SC 37301) | |
| 208600000X Surgery (Licence: CO DR-46467) | |
| 208600000X Surgery (Licence: FL 107039) | |
| 208600000X Surgery (Licence: LA 15140R) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2025-02-04 |