| NPI | 1851315972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX U7545) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME95996) |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.134400) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-11-13 |