| NPI | 1821382839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ID 1061872) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2018-00160) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2024-08-27 |