| NPI | 1700807179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MD D96725) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101231420) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-11-09 |