| NPI | 1942720396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX v1499) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX V1499) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-07-25 |