| NPI | 1851517031 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.094629) | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35094629) | 
| Enumeration Date | 2007-04-17 | 
| Last Update Date | 2022-01-25 |