| NPI | 1760703334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: OH 35.134816) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.134816) |
| 2086S0127X Surgery Trauma Surgery (Licence: OH 35.134816) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2019-07-01 |