| NPI | 1770799314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2012004001) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2012004001) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-12-07 |