| NPI | 1902803679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX J3278) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: TX J3278) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2024-02-08 |