| NPI | 1669577326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 884) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TN 1817) |
| 208600000X Surgery (Licence: TX R0439) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX R04339) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2026-07-27 |