| NPI | 1497782239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO G494990) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CA G494990) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2021-02-01 |