| NPI | 1770756884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A97614) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A97614) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA08275600) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2017-10-10 |