| NPI | 1700960689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WI 63911) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 63911-20) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-01-21 |