| NPI | 1902093545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME111076) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TN 43819) |
| 208600000X Surgery (Licence: TN 43819) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2016-11-11 |