| NPI | 1740461292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: AL 31797) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 31797) |
| 208600000X Surgery (Licence: GA 68822) | |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2016-02-08 |