| NPI | 1124448162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D91256) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: VA 1124448162) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2021-10-14 |