| NPI | 1932218500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 82943) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 34316) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AL 34316) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: AL 34316) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TN 50859) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-09-25 |