| NPI | 1801870647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: LA 018812) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: LA 018812) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2014-04-25 |