| NPI | 1821317264 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS14065)  | 
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL OS14065)  | 
| Enumeration Date | 2010-05-25 | 
| Last Update Date | 2025-09-03 |