| NPI | 1770083545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2026-02227) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MD-21044) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2026-02227) | |
| Enumeration Date | 2018-02-18 |
| Last Update Date | 2026-06-14 |