| NPI | 1760589220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 30921) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 224125-1) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 224125) | |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2024-04-02 |