| NPI | 1235660085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX U6557) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX U6557) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX U6557) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-09-27 |