| NPI | 1922319052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD194664) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX R0857) |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 73265) | |
| 208600000X Surgery (Licence: MO 2010019179) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-10-17 |