| NPI | 1912986555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: AZ 14414) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 14414) |
| 2086S0102X Surgery Surgical Critical Care (Licence: AZ 14414) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2012-07-19 |