| NPI | 1992962997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: PA MD466488) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD466488) |
| 2086S0127X Surgery Trauma Surgery (Licence: DC MD039175) | |
| 2086S0127X Surgery Trauma Surgery (Licence: ME 018866) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2024-08-23 |