| NPI | 1982964375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS017640) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: PA OS017640C) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2026-01-15 |