| NPI | 1083674782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME 28259) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: FL ME28259) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2016-11-14 |