| NPI | 1568902104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: VA 0102205372) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0102205372) |
| 208600000X Surgery (Licence: VA 0102205372) | |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2026-09-02 |