| NPI | 1649634981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0071329) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A172398) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2023-10-06 |