| NPI | 1902946247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL 88400) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IN 01082970A) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2019-10-08 |