| NPI | 1710484910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 321467) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 321467) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL OS20663) | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2025-08-18 |