| NPI | 1114094273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX N4250) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2001016337) |
| 208600000X Surgery (Licence: MO 2001016337) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX N4250) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2021-04-27 |