| NPI | 1801003355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 20284) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CO 20284) |
| 208600000X Surgery (Licence: CO 20284) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CO 20284) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CO 20284) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-01-24 |