| NPI | 1922443019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 315942) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 315942) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MN 71089) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301103306) | |
| 208600000X Surgery (Licence: MI 4301103306) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 65407) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 315942) | |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2022-07-01 |