| NPI | 1134324551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OR MD126124) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD126124) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL16173) | |
| Enumeration Date | 2007-06-16 |
| Last Update Date | 2025-04-30 |