| NPI | 1386935294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 14218879-1205) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX R3754) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2025-05-13 |