| NPI | 1083893564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A87697) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A87697) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2025-06-17 |