| NPI | 1306230826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX T9257) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME160973) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME160973) | |
| 208600000X Surgery (Licence: TX T9257) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101289258) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX T9257) | |
| 208600000X Surgery (Licence: VA 0101289258) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101289258) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME160973) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2026-04-20 |