| NPI | 1801102223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: VA 0116022565) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS018258) |
| 208600000X Surgery (Licence: VA 0116022565) | |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2022-03-31 |