| NPI | 1518196898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OK 8814) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX N5205) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX N5205) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL OS16783) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2025-04-11 |