| NPI | 1609335421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101286616) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101286616) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-09-15 |