| NPI | 1194889410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A94958) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A94958) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2024-01-05 |