| NPI | 1801107321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 37622) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT012645) |
| 2086S0127X Surgery, Trauma Surgery (Licence: SC 37622) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2024-07-10 |