| NPI | 1356722623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 284964) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A134418) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MA 284964) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2026-03-26 |