| NPI | 1962408260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO 35925) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: RI MD010789) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CO 35925) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CO 35925) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2012-05-22 |