| NPI | 1811256902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NC 242256) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-02566) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2025-08-13 |