| NPI | 1982192746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: NY 334000) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: NY 334000) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2025-08-18 |