| NPI | 1093759789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NV 28262) |
| Additional Taxonomies | 208600000X Surgery (Licence: NV 28262) |
| 2086S0127X Surgery, Trauma Surgery (Licence: AZ 29886) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2026-01-14 |