| NPI | 1700313657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX U4790) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 009050) |
| 208600000X Surgery (Licence: CA A177170) | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-05-23 |