| NPI | 1952564395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 293437) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA md458636) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MD D76238) | |
| 208600000X Surgery (Licence: MA 293437) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX N0661) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MD D76238) | |
| 208600000X Surgery (Licence: TX N0661) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2015021905) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2025-09-16 |