| NPI | 1811978596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MA 230459) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA MA230459) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MA 230459) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2010-05-17 |