| NPI | 1811277890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA MD-47943) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 70325) |
| 208600000X Surgery (Licence: CA A127071) | |
| 208600000X Surgery (Licence: MN 62443) | |
| 208600000X Surgery (Licence: WI 70325) | |
| 208600000X Surgery (Licence: OR MD190934) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MN 62443) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD190934) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IA MD-47943) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IA MD-47943) | |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2023-09-12 |