| NPI | 1417191883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD458672) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 256148) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 256148) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2025-05-15 |