| NPI | 1639599640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX S3983) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 84358) |
| 2086S0127X Surgery, Trauma Surgery (Licence: SC 84358) | |
| 208600000X Surgery (Licence: SC 84358) | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2025-11-20 |