| NPI | 1407347719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0075690) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MD D0099840) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2025-09-30 |