| NPI | 1730471376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q7900) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: AR E-11429) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2021-09-07 |