| NPI | 1598736779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A61513) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A61513) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2025-06-26 |