| NPI | 1164539953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A061858) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A061858) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2025-06-04 |