| NPI | 1770998007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL OS15838) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L0105652-0408) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 008374) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL OS15838) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2023-04-24 |