| NPI | 1558445668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX S6251) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TN MD20581) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2025-03-28 |