| NPI | 1386094357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: TX S9855) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: TX S9855) |
| 208600000X Surgery (Licence: TX S9855) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2025-08-11 |