| NPI | 1891008025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX T9256) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 25650794) |
| 208600000X Surgery (Licence: ME 21126) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX T9256) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2023-01-02 |