| NPI | 1821065525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 44207) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101270359) |
| 208600000X Surgery (Licence: GA 043004) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2018-02159) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: SC MD27791) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CO DR.0057029) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TN 44207) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX S8008) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NV 20238) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101270359) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MS 20097) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME110968) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ID M-15316) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 043004) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: LA MD.204425) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-01-04 |