| NPI | 1043545833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 60049-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD-49481) |
| 208600000X Surgery (Licence: FL trn15501) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IA MD-49481) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: WI 60049-20) | |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2024-09-11 |