| NPI | 1902898182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WI 41244-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 41244 020) |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 42169) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2025-07-22 |