| NPI | 1447305438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: DC MD600003711) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G079530) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2025-10-13 |