| NPI | 1093154825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA 163683) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT204735) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME152582) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2025-03-27 |