| NPI | 1407827306 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TN 43214)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: KY 34699)  | 
| 208600000X Surgery (Licence: TN 43214)  | |
| Enumeration Date | 2006-01-30 | 
| Last Update Date | 2023-08-10 |