| NPI | 1770567521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CA 00A710820) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: CA 00A7100820) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2021-12-13 |