| NPI | 1316386659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX v7627) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 20A17495) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2026-09-15 |