| NPI | 1922023837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301089707) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND 18410) |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036098816) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-07-21 |