| NPI | 1720347024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: SC 51915) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 51915) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2021-02-22 |