| NPI | 1740674662 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CT 71913)  | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 71913)  | 
| Enumeration Date | 2015-03-28 | 
| Last Update Date | 2025-02-24 |