| NPI | 1679069405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A160471) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 72099) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 72099) | |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2025-09-10 |