| NPI | 1790921484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MD H86203) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2017-02021) |
| 208600000X Surgery (Licence: MD H86203) | |
| 208600000X Surgery (Licence: PA OT012010) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA 0S016150) | |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2021-09-17 |