| NPI | 1871667576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MD D69632) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MD D69632) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX L6365) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2016-06-23 |