| NPI | 1760581805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX N1675) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX N1675) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2021-12-20 |