| NPI | 1598287039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MN 75671) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.071355) |
| 208600000X Surgery (Licence: WI 77811) | |
| Enumeration Date | 2017-07-15 |
| Last Update Date | 2023-12-13 |