| NPI | 1861418618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PR 009318) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CA G78966) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NM 87-375) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: DC MD30309) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |