| NPI | 1316147762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX N8379) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX N8379) |
| 208600000X Surgery (Licence: TN MD48271) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2023-03-08 |