| NPI | 1518594837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0116040393) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101287318) |
| 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101287318) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2026-07-27 |