NPI | 1962715094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX Q9839) |
Additional Taxonomies | 208600000X Surgery (Licence: TX Q9839) |
208600000X Surgery (Licence: CA A134495) | |
Enumeration Date | 2010-07-18 |
Last Update Date | 2021-11-17 |