| NPI | 1962454900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VT 042-0017059) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0040580) |
| 208600000X Surgery (Licence: PA MD495650) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MA 1026633) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MA 1026633) | |
| 208600000X Surgery (Licence: FL ME 100403) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2026-05-29 |