| NPI | 1538547286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: RI MD17142) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP03321) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2024-10-16 |