| NPI | 1487071387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX R0718) |
| Additional Taxonomies | 2086S0129X (Licence: TX R0718) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2025-08-20 |