| NPI | 1023072816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A53180) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CA A53180) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2023-10-10 |