| NPI | 1710958046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD60854012) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX Q7047) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2024-03-14 |