| NPI | 1841299005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 232695) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NY 232695-1) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 232695-1) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 232695-1) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2017-01-09 |