| NPI | 1710346465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: AL 3365) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD H93359) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2023-10-12 |