| NPI | 1396866869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 63434) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 063434) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-11-09 |