| NPI | 1437448313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX V4464) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 53518) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 53518) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: AZ 53518) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2025-02-19 |