| NPI | 1326259615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2025004765) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35086124) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2025004765) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD434514) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD434514) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2025-03-17 |