| NPI | 1205365798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A157458) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A157458) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2026-02-20 |