| NPI | 1013988484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX H7315) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 103734) |
| 208600000X Surgery (Licence: MN 51145) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2016-06-27 |