| NPI | 1841624889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 92627) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 2536086) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2022-07-08 |