| NPI | 1255697033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NM MD2018-0599) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD183678) |
| 208600000X Surgery (Licence: NM MD2018-0599) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NM MD2018-0599) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2023-07-14 |