| NPI | 1932396843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: MD D74167) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP2-0020043) |
| 2086S0127X Surgery Trauma Surgery (Licence: PA MD439888) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2023-11-16 |