| NPI | 1124259940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A120421) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A120421) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2023-06-29 |