| NPI | 1437124021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 074898) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: AL 00021026) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AL 00021026) | |
| 208600000X Surgery (Licence: NC 2023-02813) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD227334) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2026-01-15 |