| NPI | 1295359594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TN 6307) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 6307) |
| 208600000X Surgery (Licence: PA OSO26263) | |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2026-07-22 |