| NPI | 1952322083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A51663) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A51663) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA A51663) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2009-12-11 |