| NPI | 1902269764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: LA 338290) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: LA 338290) |
| 2086S0102X Surgery Surgical Critical Care (Licence: CO DR.0068372) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-08-20 |