| NPI | 1841221660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MI 4301054569) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: MI 4301054569) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-05-24 |