| NPI | 1417956111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX K4467) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX K4467) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2022-09-19 |