| 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 |