| NPI | 1689756314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: AL 9300) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 9300) |
| 208600000X Surgery (Licence: MS 13654) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2021-03-05 |