| NPI | 1679069405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 72099) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 72099) |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2024-07-29 |