| NPI | 1134577877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: TX T7656) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10056566) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2022-09-06 |