| NPI | 1902872708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 69252) |
| Additional Taxonomies | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: NM MD2019-0810) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NM MD2019-0810) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NM MD2019-0810) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2021-06-28 |