| NPI | 1063847531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WI 4474) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX T7877) |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2024-12-12 |