| NPI | 1457914020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2024-00806) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2024-00806) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2025-11-05 |