| NPI | 1356705925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 324299) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 324299) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 324299) | |
| 208600000X Surgery (Licence: CT 70277) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2026-04-03 |