| NPI | 1093759789 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 29886)  | 
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 29886)  | 
| 208600000X Surgery (Licence: AZ 29886)  | |
| Enumeration Date | 2006-06-15 | 
| Last Update Date | 2025-01-17 |