| NPI | 1114122355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DE C1-0013726) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD457506) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TN 53123) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-13 |