| NPI | 1780794149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX J2018) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX J2018) |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA J2018) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-06-22 |