| NPI | 1487693248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CO DR.0057426) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A87597) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-04-14 |