| NPI | 1245490143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0066348) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A91246) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX p3306) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2021-08-13 |