| NPI | 1639581903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 102468) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME146025) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 102468) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2025-04-17 |