| NPI | 1932346004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA C142154) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 242916-1) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2025-08-29 |