| NPI | 1174937130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME139548) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: IN 01083950A) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2022-11-17 |