| NPI | 1780055889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL OS17861) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL OS17861) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL OS17861) | |
| 208600000X Surgery (Licence: TX S5636) | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2026-06-01 |