| NPI | 1972899276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2019-01648) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102203196) |
| 208600000X Surgery (Licence: TX R3943) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2019-09-16 |