| NPI | 1730490277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: DC MD49240) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60918669) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2024-02-05 |