| NPI | 1700291150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101284247) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101284247) |
| 2086S0127X Surgery, Trauma Surgery (Licence: LA 328449) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2025-01-16 |