| NPI | 1932569282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2024-02531) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 44376) |
| 208600000X Surgery (Licence: NE 30853) | |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2024-11-15 |