| NPI | 1841486982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX M6225) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX M6225) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX M6225) | |
| Enumeration Date | 2007-09-22 |
| Last Update Date | 2023-05-08 |