| NPI | 1891137915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CA A131866) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD474064) |
| 208600000X Surgery (Licence: CA A131866) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA A131866) | |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2023-06-29 |