| NPI | 1831696178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 82161) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102208751) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0102208751) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: SC 82161) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: VA 0102208751) | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2025-08-04 |