| NPI | 1326432212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OH 34.015316) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS025865) |
| 208600000X Surgery (Licence: OH 34.015316) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 34.015316) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10052467) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2026-07-16 |