| NPI | 1043292147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 216850) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CT 046427) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2008-05-27 |