| NPI | 1588955694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A139698) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D86651) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2024-07-19 |