| NPI | 1750347563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 28773) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 38687) |
| 2086S0127X Surgery, Trauma Surgery (Licence: AL 27212) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2019-07-15 |