| NPI | 1184858797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX R7400) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A128843) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2026-05-31 |