| NPI | 1770162778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL TRN32300) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL TRN32300) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2026-08-04 |