| NPI | 1841265303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 23701) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 23701) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MI 23701) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MI 23701) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2008-09-30 |