NPI | 1255320594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX N3048) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 0101055420) |
2086S0127X Surgery, Trauma Surgery (Licence: GA 056062) | |
Enumeration Date | 2005-10-19 |
Last Update Date | 2023-03-07 |